The market for health administrators in the U.S. is projected to grow 28 percent from 2021 to 2031, growing more rapidly than the average for all other occupations.
Traditionally, those in health administration work in hospitals, large health systems, health plan organizations, and consulting firms. However, health administration has the potential to contribute value to every component of the U.S. health care system. Although health administration within independent primary care is scarce relative to the representation in hospitals and health systems, graduates of Masters of Health Administration (MHA) programs are well-equipped with foundational health care leadership knowledge that can make them powerful advocates for primary care.
Considering primary care is arguably the most important mechanism for improving the U.S. health care system, it’s time we cultivate more administrative leaders in the primary care workforce.
As a primary care physician with an MHA degree, I am fortunate to have worked in a variety of settings where health administrators held essential roles in supporting and advocating for the needs of primary care. Unlike traditional roles for health administrators – in which they often are perceived as the weaponizers of a toxic fee-for-service payment model resulting in the overworking, under-resourcing, and poor compensation of primary care – those who choose to join the primary care movement make formidable allies in the struggle to rescue primary care from destruction. Whether preparing a business case, managing vendor or payer relationships, balancing the budget, supporting the marketing strategy, developing and analyzing reports, participating in research, managing process improvement, contributing to thought leadership and policy advocacy, or overseeing the revenue cycle, health administrators work in close collaboration with clinical leaders, applying their health care business expertise to help primary care be successful. In a health care system with a reputation for devaluing primary care in lieu of providing high-ticket subspecialty care and keeping hospital beds full, health administrators who understand the crucial role of primary care as the foundation of a sustainable, affordable health care system are sorely needed.
Primary care in the U.S. is in crisis, and we need health administrators to join the fight to help us save it. In contrast to the projected growth of the health administration workforce, recent findings from the 2021 AAMC physician shortage report forecast a shortfall between 17,800 and 48,000 primary care providers by 2034 (more than any other specialty). Instead of viewing the market growth for health administration professionals with skepticism, perhaps we should recognize that health administrators can improve the healthcare system’s dismal outlook when aligned with efforts and initiatives that support high-value primary care.
Most early careerists who choose a path in health administration do so to make a positive difference in health care. It is our duty to empower these emerging health care leaders to join forces with primary care. By leveraging their unique competencies and business acumen, primary care-focused organizations gain fresh perspectives and insights into various non-clinical health care complexities, resulting in a more collaborative, strategic approach to solving issues across the primary care landscape and the health system writ large.
A literature review of administrative leadership in primary care yields virtually no resources or studies demonstrating the impact of this professional role in the primary care setting – evidence that health administrators are underrepresented in these settings compared to hospitals and health systems. This makes sense, considering how woefully under-resourced independent primary care has been for decades. However, the primary care sector of the health care industry is at the dawning of an explosion of investor-backed, innovative primary care-focused organizations poised to turn new risk-bearing payment arrangements like accountable care organizations into a generous profit. While hospitals and health systems have historically offered the highest median salary for health administrators, these professionals will soon be in high demand as part of the new era of value-based (high-value) primary care.
As payment reform shifts more health care dollars away from pay for volume to pay for value, physician leaders will have increasing incentives to work closely with health administrators in primary care settings.
It is imperative that we overhaul the failing U.S. health care system, and an important strategy to accomplish this is to create more opportunities for rising administrative health care leaders in primary care-focused organizations. No other medical specialty can improve health outcomes, increase average lifespan, positively affect patient satisfaction, and drive down wasteful spending related to the total cost of care. No other medical specialty has the ability to successfully address social determinants of health and reduce the dramatic health disparities impacting U.S. citizens, despite subpar investment in our social infrastructure relative to peer nations. In roles that support primary care, administrative health care leaders can contribute to the greater social good with the potential to save lives, increase wellness, and improve our runaway economy. Let’s get these talented business leaders seats on the primary care rocket ship.
Sara Pastoor is a family physician.
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